Premature Babies at 35 Weeks: Hurdles You May Encounter

My first pregnancy was picture-perfect. There were no complications at any time, my labor went well, and I gave birth to a very healthy and big baby boy. When my second pregnancy seemed to be the mirror image of my first, what could I conclude other than the fact that I would go full-term and give birth to another healthy baby? Unfortunately, this wasn't the case. My second son was born three weeks ago at 35 weeks' gestation, five weeks before my due date.

When my water broke the first words that came out of my mouth were "you've got to be kidding me." I was talking to no one but myself at the time, but the flux of emotions hit me hard. I went into the kitchen where my husband was expecting a business conference call from Portugal. He saw that my water had broken, no words were needed. He was a wreck. Together we tried to keep our composure as we shared our fear for our unborn child. Would he/she breath on their own? Would their hearing be up to par? Their vision? Would prematurity have an impact on them cognitively later on in life?

As I'm not a doctor, I can't answer medial questions accurately about the premature infant, but what I can do is give you an account of what we endured with our son that first week after birth. As the nurses and doctors that were caring for our son in the nursery claimed, he had very typical 35-week preemie symptoms. Here's a list of what you may encounter if you too, have a 35-week preemie.

Breathing difficulties

When I checked into the hospital in the middle of the night that night my water broke, I was led to the maternity ward by a nurse and given a small room in Triage. It was there that my OB met up with me and gave me and ultrasound to make sure the baby was doing well and was head-down. Thankfully he was. Because I was quite nervous about our child being able to breath on their own, I brought up my concern to my OB who allayed my fears. She said that from 34 to 36 weeks, they don't tend to call the babies "premature." She said that now they tend to call these babies "almost full-term" because they tend to pull through any hurdles brought their way. Great news for us. She said that she absolutely did not foresee our child not breathing on their own. Thank goodness!

When I gave birth, my husband announced that we had a boy (we had not found out), and then our son was placed on my chest. I heard him scream and it was such a wonderful sound, especially as I had worried about his ability to do so. He was measured and weighed, swaddled, and then given back to me. I was able to hold him no longer than ten minutes when our nurse told me that the little squeaking noises he was making indicated that he was having difficulty breathing. Could he breath on his own? Yes, that wasn't so much the issue. It was just hard for him to do. So he was taken away from me and placed in the nursery under an oxygen tent, a little device like a bubble that was placed over his head (I don't know the medical terminology for this device). The rest of his body was exposed. An IV was inserted into his hand and fluids were pumped into his body for nourishment as he was not to be taken out of the oxygen bubble until he was able to breath room air with no difficulties. It took a good twelve hours or so, but he pulled through. Each hour, they were able to turn down the level of oxygen that was being distributed through the bubble until it was eventually off. I learned that this was actually quite common among premature babies of my son's gestational age. One hurdle down, thank goodness.

Nursing difficulties

Once my son was off of oxygen, the bubble was taken off from around his head and I was able to hold him. We rocked in the nursery rocking chair and that's when we tried our hand at nursing. Nursing was an area that I was also concerned about as I was told by my OB when I was checked into Triage that it's also not uncommon for premature babies to have difficulty with their suck, swallow, breath reflex, and thus, have difficulty feeding. I was one of the lucky ones, that's for sure. My son latched on beautifully and has been nursing well for these past three weeks. If you do happen to have trouble nursing, take full advantage of the nurses helping you out, and absolutely ask if there is a lactation consultant working at your hospital at that time. If not, contact your local chapter of Le Leche League (http://www.llli.org/), or ask the hospital for a current list of lactation consultants in your area. Your pediatrician may also have this information on hand.

Jaundice

When an infant has Jaundice, their skin appears to have a yellow tint. You can also see this in the whites of their eyes. From what I understand, Jaundice is when there is an increased level of Bilirubin in the blood. This is normally flushed out with urine, so if your child has Jaundice, you will be encouraged to nurse/feed frequently. It's not uncommon for the Bilirubin levels in the blood to exceed a level in which they will want to treat your baby with what they call a Bilirubin Bed, or they may use the terminology "under the lights." My son was both on the bed (a device placed in his hospital crib that he had to lay on around the clock unless he was nursing), and under the lights (for these, he had to stay in the nursery with the nurses, and eye protection was required for his safety). For more information on Jaundice and the Bilirubin Bed, please refer to this site: http://www.californiawebsites.com/neo/nj2.html. It seems to explain things fairly well. My first son was Jaundice and he was full-term. It's even more common in premature infants.

Heightened startle reflex/easily overstimulated

Infants, in general, have a startle reflex. If there is a loud noise, or if you touch them unexpectedly, for example, their bodies may startle, arms splayed out, legs kicking down. The premature infant may have a heightened startle reflex, and this has absolutely been the case with my son. Even now, three weeks later, we see the startle reflex is still going strong, more so than our first son ever had. In the hospital, he startled very easily to touch. We would have to touch him very gently at first before we would pick him up, and we found that keeping a hand on him at all times when he was lifted and we were going to change positions in our arms, or hand him off to another person, kept his startle down.

Beside his startle reflex, he was very overstimulated in his first days. He needed the room to be dark and very quiet or he would become quite irritable. I saw this full-force when my sister came to visit us. It was just my sister and her six-month-old son. She held my son in her arms, handed him off to me, and then played with her son on the floor who was making squealing noises and then become cranky. She left shortly thereafter, but that had been enough for my son. For a good half hour afterward, he had to be in my arms and went from a very quiet, sleeping child, to a child that couldn't be entirely consoled. He was a bit whiny, although he didn't want to eat and didn't need a fresh diaper. My nurse visited shortly thereafter and told me about the importance of keeping it quiet for him. She told me that this is what his little body was needing right now. Yes, he had definitely become overstimulated and it didn't take that much. Luckily, I notice that this has improved tremendously. He's been in crowds with noises, he's been held by many different people, and he seems to be doing quite well with all the changes in pace. It was really just that first week that we needed to take it nice and slow.

Although these are symptoms that my son displayed when he was born five weeks early, please keep in mind that there is always risk of infection as well. It's a great idea for people to wash their hands before holding your infant, even if you've had a full-term baby. Be sure to wash your hands frequently throughout the day, especially after diaper changes. Full-term infants are susceptible to infection, but premature infants are even more at risk.

If you, too, have a 35-week premature infant, I can only hope that he/she will pull through as well as my son did and you'll be able to take them home shortly after birth. My son had an extra three-day nursery stay because of his Jaundice, but I cannot explain how wonderful it is to see how well he is thriving right now at three weeks of age.